Lung cancer is the malignant tumor with the highest incidence and mortality rate in the world, and the incidence rate is still on a rapid rise. 2002 saw about 1.35 million new cases of lung cancer and 1.18 million deaths worldwide, ranking first in malignant tumors. According to the results of the survey on the causes of death in China, the mortality rate of lung cancer increased nearly 1.5 times in the 20 years from the mid-1970s to the early 1990s, which is the fastest growing malignant tumor. The mortality rate for men ranged from 35/100,000 to 42.5/100,000; for women from 12.5/100,000 to 16/100,000. The annual number of lung cancer deaths in China is 600,000. According to epidemiologists’ estimation, by 2025, there will be 1 million new lung cancer patients in China every year due to the increase of smokers and the influence of air pollution. Lung cancer not only poses a serious threat to human health, but also leads to the breakup and poverty of families. It also imposes a huge financial burden on the country and its people. With the progress of science and technology and the development of clinical medicine, especially the rapid development of medical molecular biology and genetic testing and diagnostic technology, certain breakthroughs have been made in the pathogenesis of lung cancer. The treatment of lung cancer has entered a new era of individualized treatment from “same treatment for same disease” or “different treatment for different disease”. In other words, the treatment mode is changing from “One size fits all” to “Personalization of Cancer Care”. At present, the treatment of lung cancer is still based on the comprehensive treatment of surgery, but the efficacy of surgery has entered the plateau stage, and the 5-year overall survival rate is 70-90% for stage IA, 50-70% for stage IB, 50% for stage II, and 15% for stage III. According to a data based on 16,000 patients in 8 clinical centers in China: surgical resection rate 79.7-97.8%, complication rate 1.7-15.7%, surgical mortality rate 0.8-3.1%, 5-year overall survival rate 27.2-42.4%. Surgical treatment alone is not effective in further improving survival rates, and therefore surgery-based combination therapy has become the main treatment modality. In terms of postoperative adjuvant chemotherapy, medical oncologists and thoracic surgeons in China also overemphasize the status of adjuvant chemotherapy in stage I lung cancer. In a survey of some experts in China, 70% – 75% of the relevant physicians believed that adjuvant chemotherapy was needed after surgery for stage 1B non-small cell lung cancer, and this even included a significant number of members of lung cancer specialty committees. In fact, according to the joint ASCO and CCO guidelines for the treatment of NSCLC, adjuvant chemotherapy in stage 1B NSCLC provides a survival benefit in less than 5% of patients, and therefore, postoperative adjuvant chemotherapy is not recommended for stage 1B NSCLC. In fact, overtreatment is not only unhelpful but also very harmful. It is both wasteful in terms of resources and costs and damaging to the body. It is particularly important to note that in the treatment of locally advanced non-small cell lung cancer, there is also mono-chemotherapy as the only strategy. However, scientifically and ethically, it is clearly incorrect to treat potentially curable patients with palliative chemotherapy that is completely incurable. In clinical practice, there are still some doctors who frequently change the regimen even when the disease is under control, and “chemotherapy does not stop until life is under control”. The essence of such unregulated treatment is transitional treatment. Inadequate treatment of lung cancer patients affects the survival of patients, but the harm to the body brought by excessive treatment is quite serious and even life-threatening, which violates the purpose of tumor treatment, and also causes a great waste of social resources and impoverishes families, resulting in “people and money are empty”. revolution in advanced lung cancer treatment. However, the problem of misuse of small molecule targeted drugs has also emerged in China, which is manifested in indiscriminate application in early adjuvant therapy, late first-line therapy and concurrent application of chemotherapy. The detection of tumor biomarkers and mutation status of EGFR and other genes provides the scientific basis for individualized treatment Lung cancer is the malignant tumor with the highest morbidity and mortality, 80% of which are non-small cell lung cancer (NSCLC). Due to the lack of early diagnosis, about 75% of patients lose their first chance for surgery at the time of initial diagnosis. Clinical studies have found that only about 25% of patients can achieve long-term survival through treatment, and the main reason affecting the effectiveness of treatment and survival of NSCLC patients is tumor drug resistance. Recent studies have shown that abnormal expression of factors involved in cell signaling, abnormal DNA repair in tumor cells and other related genes are closely related to the development of drug resistance in lung cancer. Cisplatin-containing regimens are the main regimen of chemotherapy for NSCLC, and Excision repair crosscomplementation group 1 (ERCC1) is a highly conserved excisional nuclease in nucleotide excision repair and is required for effective repair of alkylator-induced DNA adducts. ERCC1 is currently used to predict whether patients are sensitive to cisplatin, and ERCC1-negative patients can significantly benefit from cisplatin-containing chemotherapy. Studies have reported that mismatch repair protein 2 (MSH2) is used to repair DNA damaged by platinum drugs, so MSH2 may be used along with ERCC1 as a predictor of long-term benefit from adjuvant chemotherapy in NSCLC. Factors involved in signaling that mediate drug resistance include P13-K/AKt, NF-kapaB, protein kinase C, etc. Protein kinase C (PKC) belongs to the serine/threonine protein kinase family, which regulates growth factor responses and cell proliferation and apoptosis, and is involved in tumorigenesis, development and response to antitumor drugs. paclitaxel, and found that the downregulation of PKC & levels significantly enhanced the activity of the apoptotic factor caspase-3 and promoted apoptosis on the one hand; on the other hand, it increased the consumption of mitochondrial membrane proteins induced by vincristine and enhanced the sensitivity of A549 cells to cytotoxic drugs, thus, PKC & may be an important therapeutic target. Epidermal growth factor receptor (EGFR) is a glycoprotein receptor on the surface of cell membranes that, when activated by EGFR binding to ligands, transmits signals into cells through a series of pathways to stimulate cell growth and proliferation. Studies on the distribution and expression of EGFR in lung cancer have confirmed that EGFR expression is low in normal lung tissues; EGFR overexpression exists in NSCLC, especially in squamous carcinomas. Since high expression of EGFR can promote tumor cell proliferation, tumor angiogenesis, adhesion, invasion and metastasis and antagonize apoptosis of tumor cells, and EGFR tyrosine kinase is necessary for signaling, EGFR has become an important target for tumor therapy. With the improvement of molecular biology research technology and in-depth research, the detection of drug resistance molecular indicators in refractory NSCLC patients can not only clarify the drug resistance mechanism of lung cancer patients, but also provide an important reference basis for clinical individualization of lung cancer patients, drug resistance reversal research and molecular targeting therapy. The implementation of individualized treatment plan for lung cancer should take into account the patient’s age, gender, smoking history, functional status (PS score), pathological type, tumor grading and staging, and molecular biomarker detection. The specific individualized treatment includes the following aspects: individualized surgical treatment, individualized chemoradiotherapy, individualized molecular targeted therapy, and individualized comprehensive treatment plan design and adjuvant therapy. 1.Individualized surgical treatment: Surgery is the most basic and important method of tumor treatment. Complete removal of tumor is the most ideal and the most effective way, including stage I and II patients without lymph node metastasis. Most patients are already in stage III or IV when they are seen, which makes complete removal of tumor difficult, which requires surgical experts to design the best way to perform surgery and expand it if necessary to achieve radical treatment. When lung cancer invades the superior vena cava and causes superior vena cava syndrome (SVCS), superior vena cava resection and artificial vascular reconstruction can be performed; maximizing lung cancer removal and maximizing lung function preservation are the principles that must be followed in lung cancer surgical treatment. When the tumor invades the pulmonary artery trunk, double sleeve resection of pulmonary artery and bronchus can be performed in order to avoid the possible pulmonary insufficiency caused by total lung resection. The development of thoracoscopic surgery is very rapid, with the advantages of small trauma, quick recovery and short hospital stay. We routinely carry out thoracoscopic lung cancer resection and achieve good results. 2.Individualized chemoradiotherapy: locally advanced NSCLC accounts for about 50% of diagnosed lung cancer. In recent years, multicenter clinical follow-up trial studies and meta-analysis have confirmed that integrated chemoradiotherapy is better than chemotherapy alone, and also better than radiotherapy alone, and some of them are similar to the effect of surgery. Meanwhile, studies have shown that synchronized chemoradiotherapy is better than sequential radiotherapy, but synchronized chemoradiotherapy is suitable for patients in good physical condition, and patients with serious medical diseases are not suitable for synchronized chemoradiotherapy to avoid aggravating systemic diseases. Chemotherapy regimens include GP, TP, DP, etc. Pemetrexed plus platinum has good effect on adenocarcinoma patients and is a new option. The choice of chemotherapy regimen should also refer to the detection of biomarker proteins for lung cancer to optimize the chemotherapy regimen or to determine the effectiveness and prognosis of chemotherapy. Individualized chemotherapy under the guidance of biomarker protein is the development direction. 3.Individualized molecular targeted drug therapy: Since the introduction of the world’s first targeted drug ERSA in 2002, targeted drugs have been on the historical stage of lung cancer treatment, and with the in-depth research on the genomics of cell conduction pathways, more and more targeted drugs have started to enter the clinic, from small molecules to monoclonal antibodies, from signaling pathway blockers to anti-vascular drugs. The representative drugs of EGFR inhibitors include EGFR tyrosine kinase inhibitors and anti-EGFR monoclonal antibodies, and the representative drugs of EGFR tyrosine kinase inhibitors are gefitinib and erlotinib. The representative drugs of anti-EGFR monoclonal antibodies are cetuximab. In the postoperative adjuvant therapy of NSCLC, the cytotoxic effect of platinum-containing regimen chemotherapy as the first target of anti-tumor therapy can kill the tiny postoperative residual tumor cells, while anti-angiogenic drugs as the second target can reduce the formation of tumor neovascularization, thus reducing and delaying tumor recurrence and metastasis and improving long-term survival of lung cancer patients. In conclusion, the treatment of lung cancer must be based on the actual situation of patients, tumor stage, pathological staging and bioprotein marker test results to formulate practical, feasible and effective individualized treatment plans in order to avoid ineffective treatment, reduce cost, improve efficacy and prolong life. Individualized treatment of lung cancer has a long way to go and a bright future.